- Research and suggest training opportunities related to anti-racism for health service providers on campus.
- Research and suggest training of existing counsellors to understand the psycho-socioeconomic BIPOC-lens.
To inform these recommendations, the Working Group reviewed journal articles that examined health inequities experienced by racialized communities; conducted a detailed environmental scan on anti-racism training and training on the social determinants of health for medical professionals and counsellors; and conducted interviews and focus groups with counsellors, campus healthcare providers (i.e., physicians, psychiatrists, and nurses) and other specialists in the community (an Indigenous physician, a community-based female Muslim counsellor, and an anti-racism expert).
Results of these reviews and consultations indicate that racism is prevalent in Canada’s healthcare system. These inequities are rooted in colonial and racist ideologies and worldviews, stereotypes, prejudice, and discrimination. Institutional factors and individual behaviours that contribute towards these inequities in healthcare and health outcomes include language barriers; lack of cultural awareness; cultural responsiveness; cultural safety5; unconscious biases; inaccessible/inappropriate screening services; unfounded beliefs in race-based biological differences; and a lack of awareness/familiarity of these important issues and concepts.
The proposed anti-racism training is based on the Working Group’s reviews and consultations, and on important frameworks such as Critical Race Theory.
The following are anti-racism training recommendations for health service providers and counsellors. They are grouped into five broad categories (detailed information on these categories is provided in Appendix C):
- A | Introduction to Anti-racism/Anti-racism Fundamentals To provide an understanding of fundamental anti-racism context, principles, and terms, including colonization; racial and cultural awareness; eurocentrism; racial discrimination and harassment; whiteness, white privilege, and white supremacy; microaggressions; and unconscious biases.
- B | Social Determinants of Health To provide an understanding of how to address the negative impacts of the social determinants of health and intersectionality in clinical practice, with an emphasis on Black, Indigenous, and other racialized persons.
- C | Racism and Discrimination in Healthcare To provide an understanding of structural racism and discrimination in the Canadian healthcare system.
- D | Culturally Responsible and Safe Healthcare/ Anti-racist Framework for Clinical Practice To provide an anti-racism lens to the work of healthcare providers.
- E | Racial and Intergenerational Trauma To provide an understanding of how to manage the adverse impact of racial and intergenerational trauma, experienced by Black, Indigenous, and other racialized persons.
Discuss and offer suggestions to provide virtual meeting safe places/healing spaces and approaches to support BIPOC students/staff/faculty who experience racism to learn strategies to address mental health and anxiety, and to provide a venue for sharing stories of hope and encouragement.
In postsecondary settings, safe spaces refer to physical spaces on campuses that are devoted to the needs of equity-deserving groups. Safe spaces can also refer to organizations or specific gatherings (e.g., campus cultural centers, racialized student organizations, and specialized classes, workshops, or events). Moreover, these spaces can also be called healing spaces when they are devoted to helping equity-deserving groups, such as racialized individuals, heal from racial and inter-generational trauma.
The goal of the recommendations below is to specifically address safe/healing space needs of Black, Indigenous, and other racialized groups at the University of Waterloo – to help these individuals build connections and a sense of community in a respectful environment.
Recommendations were informed by experiences shared by the University’s graduate and undergraduate students (via WUSA and GSA) and employees in departments/units that offer various services, supports and resources. Consultations were also done with various units including Campus Wellness, Campus Housing, Athletics and Recreation, Student Success Office, and Co-operative Education. An environmental scan and academic literature on safe/healing spaces were also reviewed to inform these recommendations.
Develop group-specific healing circles that serve the needs of Black, Indigenous, or other racialized groups. Special consideration should also be given to those with intersecting identities (e.g., with differing sexual orientations and gender identities). These healing circles should offer resources and strategies to deal with mental health challenges (e.g., anxieties), should be empowering, and should promote stories of resiliency.
Ensure that the facilitators of healing circles are trained in the best practices (e.g., regular check-ins with participants) for creating culturally safe spaces, have a background in healing, and come from the same/similar background as those they serve/participants (e.g., Indigenous Elders, Black counsellors, spiritual healers from various faith communities).
Provide opportunities for international students to freely and safely discuss their experiences in a new/unknown environment, obtain strategies to effectively navigate new systems, and learn how to cope with stressors that they might encounter.
Designate ‘safe’ physical spaces (e.g., indoor spaces, community gardens) that can be used by racialized students and employees to heal from racial and intergenerational trauma. Place clear physical markers outside these spaces for ease in locating them.
Maintain an easily accessible resource list of healing/safe spaces on campus and in the Region of Waterloo (see Appendix D). Distribute this list to health service providers regularly.
Provide recommendations for strategies to increase BIPOC mental wellness services, supports and resources.
Physical and mental wellbeing is dependent on both lifestyle choices and on individual, social, economic, and other factors that are outside of one’s control. These latter factors, which are the largest predictors of sickness, are called social determinants of health (SDOH). When SDOH (e.g., race, income, educational status, employment, housing, disability, gender identity) cause economic and social disadvantage, they create systemic barriers for individuals to access healthcare opportunities, resources, and services. Using a SDOH lens and in consultation with diverse stakeholders across campus, the recommendations were developed that will extend wellness services, supports and resources beyond those typically provided by counsellors, physicians, psychiatrists, and nurses in Campus Wellness. Environmental scans and literature reviews also informed the recommendations.
Black, Indigenous, and other racialized students, faculty and staff may not have enough information on the mental health and wellness services and supports that are available to them. The University should expand its current Wellness Resources Database to include services on and off campus that are tailored to members of the Black, Indigenous, and other racialized communities, such as non-Western clinical services and practices (e.g., Indigenous healing practices, Chinese medicine, Ayurveda, acupressure/ acupuncture, homoeopathy, naturopathy, non-Western nutritional and dietary services). See Appendix E for a list of resources.
Health service providers should be able to competently refer students to on and off campus supports for emergency loans, access to affordable and nutritious food, housing, or childcare.
When students are referred to community services, a proper follow-up should be conducted to ensure that the students’ needs have been met in a culturally appropriate and satisfactory manner.
UWaterloo Chaplains should expand the number of faith traditions it represents to meet the needs of the University’s diverse population, as spiritual wellness supports are important to members of racialized groups. In addition, this campus unit should consider a more inclusive name for spiritual leaders (except Christian and Catholic leaders) other than “chaplains”, as this word has its roots in Christianity, and may act as a barrier to some of those seeking spiritual help.
Extend services to students’ immediate family members, if deemed appropriate for the wellness of students. When appropriate, ensure family members are referred to appropriate community organizations.
Develop recommendations for where increased support for health and mental health would be most effective.
In addition to providing recommendations that will extend wellness services, supports, and resources beyond those typically provided by counsellors, physicians, psychiatrists, and nurses in Campus Wellness, strategies to improve the services provided by these healthcare providers were also discussed. Attention was also given to decolonizing existing services, supports and resources before recommending an increase to them. Like the previous ones, these recommendations were developed in consultation with diverse stakeholders across campus (Campus Wellness, Campus Housing, Athletics and Recreation, the Student Success Office, Co-operative Education). Environmental scans and literature reviews also informed them.
Ensure healthcare practitioners have diverse cultural, linguistic, and faith/ spiritual backgrounds to provide culturally responsible and safe services that are reflective of the diversity of students.
Increase the number of counseling sessions for students and/or evaluate ways to refer students to affordable community counselling services, as deemed necessary by clinical analysis, as the six-sessions counseling model may be insufficient to address certain mental health challenges.
Develop culturally sensitive and responsible group therapy workshops, seminar programs, and peer health educational programs to address the unique challenges faced by racialized students, in particular racial trauma. Use names for these workshops and programs that are not perceived as stigmatizing by non-Western cultures (e.g., ‘tools for living your best life’ vs. ‘therapy group’). Offer these workshops and programs during vulnerable times (e.g., co-op terms, exams).
Explain counselling and health services intake processes on the internal website with greater clarity:
- Provide transparency about the process of switching counselors and transferring to an off-campus service.
Provide information to community members, especially faculty, to recognize when students could benefit from wellness checks and might need mental health support.
Recommend how a BIPOC lens could be included into the wellness collaborative that addresses the social determinants of health.
The Wellness Collaborative (WC) was launched in June 2019, with the signing of the Okanagan Charter and the Healthy Workplace Statement and addresses the wellbeing of the entire university community.
For the Wellness Collaborative to achieve its mandate, recommendations have been developed under eight broad categories and are discussed on the right.
Build relationships, trust, safety, and communications
Develop and implement a communication and engagement strategy for connecting with Black, Indigenous, and other racialized persons.
Decolonize the Wellness Collaborative’s understanding of and approaches to wellness, specifically mental wellness, by consulting with wellness professionals and traditional knowledge keepers from different cultures and incorporating various cultural perspectives on wellness in programs and initiatives.
The wellness priority areas of the Wellness Collaborative should be informed by additional consultations with Black, Indigenous, and other racialized individuals, equity-deserving groups, and other relevant groups for revising (or redeveloping) the priorities.
Terminology and approach
Identify the systemic barriers or inequities caused by social and structural determinants of health that may negatively impact the inclusion of equity deserving groups in the Wellness Collaborative and engage in actions that proactively mitigate the identified barriers or inequities.
History and current socio-political realities
The Wellness Collaborative Advisory Committee and Community of Practice members should participate in educational programs and learning activities, with a focus on historical, structural, and legacy impacts of colonialism on Black, Indigenous, and other racialized persons.
Review, adopt and enact relevant health-related calls to action (i.e., no. 18 to 24) from the Truth and Reconciliation Commission’s (TRC’s) report.
Incorporate equity, diversity and inclusion (EDI)
Ensure that the racial and cultural composition of the Wellness Collaborative Advisory Committee and Community of Practice reflect the demographic of the community they serve. Provide equitable access of Wellness Collaborative programming and initiatives to all of campus community.
Evaluation and sustainability
- A | Use program evaluative tools to identify intended and unintended impacts of the Wellness Collaborative’s work on Black, Indigenous, other racialized persons and other equity-deserving groups.
- B | Develop process and outcome success indicators that apply to Black, Indigenous, and other racialized persons. Ensure that the process and outcome success indicators are culturally applicable.